A Victory For The Disabled

December 18, 1999|By MARC LACEY The New York Times

WASHINGTON - — - With advocates for the disabled gathered around him at the Franklin Delano Roosevelt Memorial, President Clinton on Friday signed landmark legislation that could allow millions of people with disabilities to enter the work force by lifting restrictions on their health care coverage.

Advocates consider the legislation the most significant step for the disabled since the Americans with Disabilities Act of 1990. The law expands Medicaid and Medicare so that people with disabilities will continue to receive health insurance coverage after they go to work.

Clinton signed the legislation, called the Work Incentives Improvement Act, at the base of the larger-than-life bronze of Roosevelt, whom the president has called the greatest chief executive of the century for his attention to social programs and a safer world. Roosevelt had polio and, unknown to most Americans at the time, used a wheelchair for much of his life.

"In his time, Roosevelt felt he needed to keep his wheelchair from public view," Clinton said. "Most people believed being disabled meant being unable. He proved them wrong every day."

It is fitting, Clinton said, that the law will be the last any president signs this century.

Sen. Edward Kennedy, D-Mass., a sponsor of the bill, said it would "swing open the long-closed doors of the workplace for millions of disabled men and women."

Under the previous law, disabled people often lost Medicaid and Medicare coverage because their income rose when they went to work. Even with private insurance from their employers, they often could not afford the costly health care or medical equipment they required.

"This defies common sense and economic logic," Clinton said.

The legislation, which won broad bipartisan support in Congress, changes rules that discourage many disabled people from working. Under the current system, fewer than 1 percent of the 8 million disabled people of working age who receive benefits from Social Security and Supplemental Security Income work.

Many Democrats, including Kennedy, stressed the law's civil rights implications, while Republicans touted it as a way to end government dependence.

"Millions of Americans are waiting eagerly to unleash their creativity and to pursue the American dream," said Rep. Rick Lazio, R-N.Y., a House sponsor of the bill. "By helping them break free of the shackles of dependency, we help them gain the freedom to achieve their goals."

Clinton said the primary argument for the legislation was a human one: to prevent people from having to choose between work and health care. But he said the legislation also made economic sense. "One way we can keep this economic expansion going is to take it to people and places who aren't part of it," he said.

James Sullivan, 38, of Hudson, N.H., introduced Clinton, recounting how he became disabled two days before his 18th birthday, when he broke his neck in a diving accident.

"This system, which basically makes people stay at home and punishes them when they work, is a crazy one," said Sullivan, who is eager to get a job in the telecommunications industry. "There is an untapped population of Americans with disabilities who are dying to get back to work."

The legislation, with provisions that will be phased in, provides $150 million for grants to encourage states to allow disabled workers to buy into Medicaid. It sets aside $250 million to help obtain Medicaid coverage for people who are not so disabled that they cannot work.

The law also increases to 550,000 the number of disabled people who will receive rehabilitation and training services in the next 10 years. It also includes a provision concerning organ transplant policy opposed by the Clinton administration.

The transplant provision delays by 90 days controversial regulations that were scheduled to take effect this year. Now the rules -- aimed at directing more-scarce organs to the sickest patients -- won't take effect until mid-March at the earliest.

Leye Jeannette Chrzanowski, who runs the Disability News Service in Chantilly, Va., and has a neurological disorder, considered the legislation groundbreaking. But she could have done without all the symbolic references to Roosevelt.

"Lots of people with spinal cord injuries are very sensitive to temperature," Chrzanowski said. "It's aesthetically pleasing to have FDR behind us, but with the temperature like this, we all ought to be inside."

Information from The Associated Press was used to supplement this report.